Three-dimensional computed tomographic assessment of mandibular muscles in growing subjects with different vertical facial patterns

Aim: The present study was undertaken to assess the relationship between the mandibular muscles and dentofacial skeletal morphology in children with different underlying vertical facial patterns, using three-dimensional computed tomography (3D-CT). Method: Thirty children (mean age 12.24 +/- 1.57 years) underwent cranial CT examination for diagnostic purposes. 3D-CT images were reconstructed for the evaluation of the cross-sectional size, volume, and spatial orientation of the masseter and medial pterygoid muscles. These muscle parameters were also assessed in relation to the vertical facial pattern, gender and skeleto-dental form. Results: Significant differences were found in muscular angulation for subjects with different underlying patterns. Greater masseter volumes were associated with increased facial width. Greater intermolar widths were found in brachyfacial subjects, with less acute muscular angulations in relation to horizontal reference lines, compared with dolichofacial subjects. This was also more obvious in the maxillary arch. Conclusion: Clinicians should note the likely differences in masseter and medial pterygoid orientation and volume in subjects with different underlying vertical facial patterns and that these differences may, in turn, be related to both facial skeletal width and naturally-occurring transverse dental arch dimensions.